In human plasma, the composition and concentration of circulating lipoproteins is strongly influenced by cholesteryl ester transfer protein (CETP). Given its importance in lipoprotein metabolism and potential influence on atherosclerosis, the regulation of CETP activity has been the subject of extensive study. We have identified a plasma protein, lipid transfer inhibitor protein (LTIP), that regulates CETP activity. Recently, we purified, cloned and expressed LTIP and demonstrated its identity with apolipoprotein F, a protein with no known function. We propose that LTIP is a lipid flux switch that regulates CETP, not by suppressing CETP activity generally, but by selectively interfering with lipid transfer events to and from LDL. This selectivity toward LDL appears to be mediated by the preferential association of LTIP with LDL in plasma. Several lines of evidence from in vitro and in vivo studies strongly suggest that LTIP is a physiological modulator of lipoprotein concentration and composition. Our long-term objective is to define the role of LTIP in regulating lipoprotein metabolism and to define its impact on atherogenesis. In this proposal we further define the role of LTIP in vivo, identify its mechanism of action, and characterize mechanisms regulating its synthesis and secretion. In vitro and in vivo studies test the hypothesis that remnants of VLDL catabolism acquire LTIP as they near LDL in size, which alters their CETP-substrate status and determines the nature of the end- products of VLDL catabolism (Aim 1). Kinetic and lipid monolayer studies with recombinant LTIP, and lipoprotein modification and LTIP mutagenesis studies will determine the mechanism of LTIP's action and define the properties of lipoproteins and the structural features of LTIP that are required for activity (Aim 2). Finally, biochemical and molecular studies with cultured cells and tissue-specific expression analyses will be used to test the hypothesis that LTIP and CETP are co-expressed and co- regulated in response to cellular cholesterol homeostasis (Aim 3). Overall, these studies will provide novel insights into a poorly characterized modulator of cholesterol flux in human plasma.